[Serum bile acids in acute hepatitis. Clinical observations]

Diagnostic and prognostic significance of total bile acids concentrations has been evaluated in 26 patients with acute viral hepatitis. The levels of fasting and post-prandial blood cholates have been compared with the values found in normal subjects, in 20 patients with extrahepatic pathology and in 10 cases of non-viral icteric diseases. A remarkable rise in serum bile acids concentration has been showed in acute stage of hepatitis; the level of cholates is significantly higher in cholangitic jaundice, but difference is not found in respect of patients with extrahepatic cholestasis. The improvement of disease decreases the serum bile acids concentration; the decrease going on at the same rate of serum transaminases lowering but preceding the serum bilirubin one. No difference was found between fasting and post-prandial blood cholates. In conclusion, serum bile acids concentration has no diagnostic value in hepatitis, nevertheless it seems an useful test for monitoring the course of the hepatitic disease.

Serum gamma-glutamyltransferase isoenzymes in extrahepatic biliary obstruction

The gamma-glutamyltransferase isoenzymes in the sera of patients with extrahepatic biliary obstruction have been studied, using electrophoretic, gel filtration, and ultracentrifugation techniques, and compared with those present in normal sera. Five isoenzymes were shown to exist in patients' sera, three of which were not demonstrated in normal sera. The observations are discussed in relation to the influence of biliary regurgitation and the possible solubilisation of membrane-bound enzymes. The results are compared with those of previous studies on alkaline phosphatase.